Epicardial ablation via the coronary sinus offers a viable alternative approach for refractory ventricular tachycardia in non-ischemic cardiomyopathy when endocardial ablation fails.
May warrant consideration of coronary sinus epicardial access for refractory VT after endocardial failure; leaves open prospective validation.
We report a case of a 69-year-old male with non-ischemic cardiomyopathy, having drug- and antitachycardia pacing-refractory ventricular tachycardia resulted in multiple ICD shocks. The sustained and intractable ventricular arrhythmia was mapped and ablated with the aid of the three-dimensional electroanatomic mapping system, initially performed but unsuccessful from the endocardial site then performed successfully from the epicardial site via the coronary sinus.
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Aras et al. (2014) studied this question.
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